Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis

Volume 326:975-982		April 9, 1992		Number 15

Subcutaneous low-molecular-weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis

RD Hull, GE Raskob, GF Pineo, D Green, AA Trowbridge, CG Elliott, RG Lerner, J Hall, T Sparling, HR Brettell, and et al.

Add to Personal Archive

Add to Citation Manager

Notify a Friend

E-mail When Cited

PubMed Citation

Abstract

BACKGROUND. Low-molecular-weight heparin has a high bioavailability and a prolonged half-life in comparison with conventional unfractionated heparin. Limited data are available for low-molecular-weight heparin as compared with unfractionated heparin for the treatment of deep-vein thrombosis. METHODS. In a multicenter, double-blind clinical trial, we compared fixed-dose subcutaneous low-molecular-weight heparin given once daily with adjusted-dose intravenous heparin given by continuous infusion for the initial treatment of patients with proximal-vein thrombosis, using objective documentation of clinical outcomes. RESULTS. Six of 213 patients who received low-molecular-weight heparin (2.8 percent) and 15 of 219 patients who received intravenous heparin (6.9 percent) had new episodes of venous thromboembolism (P = 0.07; 95 percent confidence interval for the difference, 0.02 percent to 8.1 percent). Major bleeding associated with initial therapy occurred in 1 patient receiving low-molecular-weight heparin (0.5 percent) and in 11 patients receiving intravenous heparin (5.0 percent), a reduction in risk of 91 percent (P = 0.006). This apparent protection against major bleeding was lost during long-term therapy. Minor hemorrhagic complications were infrequent. Ten patients receiving low-molecular-weight heparin (4.7 percent) died, as compared with 21 patients receiving intravenous heparin (9.6 percent), a risk reduction of 51 percent (P = 0.049). CONCLUSIONS. Low-molecular-weight heparin is at least as effective and as safe as classic intravenous heparin therapy under the conditions of this study and more convenient to administer. The simplified therapy provided by low-molecular-weight heparin may allow patients with uncomplicated proximal deep-vein thrombosis to be cared for in an outpatient setting.

Source Information

Division of General Internal Medicine, University of Calgary, Alberta, Canada.

This article has been cited by other articles:

Authors/Task Force Members, , Torbicki, A., Perrier, A., Konstantinides, S., Agnelli, G., Galie, N., Pruszczyk, P., Bengel, F., Brady, A. J.B., Ferreira, D., Janssens, U., Klepetko, W., Mayer, E., Remy-Jardin, M., Bassand, J.-P., ESC Committee for Practice Guidelines (CPG), , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Document Reviewers, , Zamorano, J.-L., Andreotti, F., Ascherman, M., Athanassopoulos, G., De Sutter, J., Fitzmaurice, D., Forster, T., Heras, M., Jondeau, G., Kjeldsen, K., Knuuti, J., Lang, I., Lenzen, M., Lopez-Sendon, J., Nihoyannopoulos, P., Perez Isla, L., Schwehr, U., Torraca, L., Vachiery, J.-L. (2008). Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 29: 2276-2315 [Full Text]
Schulman, S., Beyth, R. J., Kearon, C., Levine, M. N. (2008). Hemorrhagic Complications of Anticoagulant and Thrombolytic Treatment: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 257S-298S [Abstract] [Full Text]
Kearon, C., Kahn, S. R., Agnelli, G., Goldhaber, S., Raskob, G. E., Comerota, A. J. (2008). Antithrombotic Therapy for Venous Thromboembolic Disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 133: 454S-545S [Abstract] [Full Text]
Bellosta, R., Ferrari, P., Luzzani, L., Carugati, C., Cossu, L., Talarico, M., Sarcina, A. (2007). Home Therapy With LMWH in Deep Vein Thrombosis: Randomized Study Comparing Single and Double Daily Administrations. ANGIOLOGY 58: 316-322 [Abstract]
Dager, W. E, King, J. H, Branch, J. M, Chow, S. L, Ferrer, R. E, Pak, S., Togioka, P. Y, White, R. H (2005). Tinzaparin in Outpatients with Pulmonary Embolism or Deep Vein Thrombosis. The Annals of Pharmacotherapy 39: 1182-1187 [Abstract] [Full Text]
Wells, P. S., Anderson, D. R., Rodger, M. A., Forgie, M. A., Florack, P., Touchie, D., Morrow, B., Gray, L., O'Rourke, K., Wells, G., Kovacs, J., Kovacs, M. J. (2005). A Randomized Trial Comparing 2 Low-Molecular-Weight Heparins for the Outpatient Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Arch Intern Med 165: 733-738 [Abstract] [Full Text]
Zed, P. J., Filiatrault, L., Busser, J. R. (2005). Outpatient treatment of venous thromboembolic disease based in an emergency department. Am J Health Syst Pharm 62: 616-619 [Abstract] [Full Text]
Fiessinger, J.-N., Huisman, M. V., Davidson, B. L., Bounameaux, H., Francis, C. W., Eriksson, H., Lundstrom, T., Berkowitz, S. D., Nystrom, P., Thorsen, M., Ginsberg, J. S., for the THRIVE Treatment Study Investigators, (2005). Ximelagatran vs Low-Molecular-Weight Heparin and Warfarin for the Treatment of Deep Vein Thrombosis: A Randomized Trial. JAMA 293: 681-689 [Abstract] [Full Text]
Pineo, G. F., Hull, R. D. (2005). Low-Molecular-Weight Heparin for the Treatment of Venous Thromboembolism in the Elderly. CLIN APPL THROMB HEMOST 11: 15-23 [Abstract]
Hirsh, J., Raschke, R. (2004). Heparin and Low-Molecular-Weight Heparin: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 188S-203S [Abstract] [Full Text]
Levine, M. N., Raskob, G., Beyth, R. J., Kearon, C., Schulman, S. (2004). Hemorrhagic Complications of Anticoagulant Treatment: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 126: 287S-310S [Abstract] [Full Text]
Augustinos, P., Ouriel, K. (2004). Invasive Approaches to Treatment of Venous Thromboembolism. Circulation 110: I-27-I-34 [Abstract] [Full Text]
Elting, L. S., Escalante, C. P., Cooksley, C., Avritscher, E. B. C., Kurtin, D., Hamblin, L., Khosla, S. G., Rivera, E. (2004). Outcomes and Cost of Deep Venous Thrombosis Among Patients With Cancer. Arch Intern Med 164: 1653-1661 [Abstract] [Full Text]
Quinlan, D. J., McQuillan, A., Eikelboom, J. W. (2004). Low-Molecular-Weight Heparin Compared with Intravenous Unfractionated Heparin for Treatment of Pulmonary Embolism: A Meta-Analysis of Randomized, Controlled Trials. ANN INTERN MED 140: 175-183 [Abstract] [Full Text]
Linkins, L.-A., Choi, P. T., Douketis, J. D. (2003). Clinical Impact of Bleeding in Patients Taking Oral Anticoagulant Therapy for Venous Thromboembolism: A Meta-Analysis. ANN INTERN MED 139: 893-900 [Abstract] [Full Text]
Nutescu, E. A, Shapiro, N. L, Feinstein, H., Rivers, C. W (2003). Tinzaparin: Considerations for Use in Clinical Practice. The Annals of Pharmacotherapy 37: 1831-1840 [Abstract] [Full Text]
Mousa, S. A., Bozarth, J., Barrett, J. S. (2003). Pharmacodynamic Properties of the Low Molecular Weight Heparin, Tinzaparin: Effect of Molecular Weight Distribution on Plasma Tissue Factor Pathway Inhibitor in Healthy Human Subjects. J Clin Pharmacol 43: 727-734 [Abstract] [Full Text]
Nutescu, E. A, Lewis, R. K, Finley, J. M, Schumock, G. T (2003). Hospital Guidelines for Use of Low-Molecular-Weight Heparins. The Annals of Pharmacotherapy 37: 1072-1081 [Abstract] [Full Text]
Raschke, R., Hirsh, J., Guidry, J. R. (2003). Suboptimal Monitoring and Dosing of Unfractionated Heparin in Comparative Studies with Low-Molecular-Weight Heparin. ANN INTERN MED 138: 720-723 [Abstract] [Full Text]
Hyers, T. M. (2003). Management of Venous Thromboembolism: Past, Present, and Future. Arch Intern Med 163: 759-768 [Abstract] [Full Text]
Dalen, J. E. (2002). Pulmonary Embolism: What Have We Learned Since Virchow?: Treatment and Prevention. Chest 122: 1801-1817 [Full Text]
Backe, S. K., Lyons, G. R. (2002). High-dose tinzaparin in pregnancy and the need for urgent delivery. Br J Anaesth 89: 331-334 [Abstract] [Full Text]
Kakkar, V. V., Hoppenstead, D. A., Fareed, J., Kadziola, Z., Scully, M., Nakov, R., Breddin, H. K. (2002). Randomized trial of different regimens of heparins and in vivo thrombin generation in acute deep vein thrombosis. Blood 99: 1965-1970 [Abstract] [Full Text]
Tait, R C (2001). Anticoagulation in patients with thromboembolic disease. Thorax 56: ii30-37 [Full Text]
Hirsh, J., Anand, S. S., Halperin, J. L., Fuster, V. (2001). Guide to Anticoagulant Therapy: Heparin : A Statement for Healthcare Professionals From the American Heart Association. Arterioscler. Thromb. Vasc. Bio. 21 : e9-e9 [Full Text]
Hirsh, J., Anand, S. S., Halperin, J. L., Fuster, V. (2001). Guide to Anticoagulant Therapy: Heparin : A Statement for Healthcare Professionals From the American Heart Association. Circulation 103: 2994-3018 [Full Text]
De Lorenzo, F., Noorani, A., Kakkar, V.V. (2001). Current trends in the management of thromboembolic events. QJM 94: 179-185 [Full Text]
Hirsh, J., Bates, S. M. (2001). Clinical Trials That Have Influenced the Treatment of Venous Thromboembolism: A Historical Perspective. ANN INTERN MED 134: 409-417 [Abstract] [Full Text]
Breddin, H. K., Hach-Wunderle, V., Nakov, R., Kakkar, V. V., The CORTES Investigators, (2001). Effects of a Low-Molecular-Weight Heparin on Thrombus Regression and Recurrent Thromboembolism in Patients with Deep-Vein Thrombosis. NEJM 344: 626-631 [Abstract] [Full Text]
Merli, G., Spiro, T. E., Olsson, C.-G., Abildgaard, U., Davidson, B. L., Eldor, A., Elias, D., Grigg, A., Musset, D., Rodgers, G. M., Trowbridge, A. A., Yusen, R. D., Zawilska, K., for the Enoxaparin Clinical Trial Group*, (2001). Subcutaneous Enoxaparin Once or Twice Daily Compared with Intravenous Unfractionated Heparin for Treatment of Venous Thromboembolic Disease. ANN INTERN MED 134: 191-202 [Abstract] [Full Text]
Hirsh, J., Warkentin, T. E., Shaughnessy, S. G., Anand, S. S., Halperin, J. L., Raschke, R., Granger, C., Ohman, E. M., Dalen, J. E. (2001). Heparin and Low-Molecular-Weight Heparin Mechanisms of Action, Pharmacokinetics, Dosing, Monitoring, Efficacy, and Safety. Chest 119 : 64S-94S [Full Text]
Levine, M. N., Raskob, G., Landefeld, S., Kearon, C. (2001). Hemorrhagic Complications of Anticoagulant Treatment. Chest 119 : 108S-121S [Full Text]
Hyers, T. M., Agnelli, G., Hull, R. D., Morris, T. A., Samama, M., Tapson, V., Weg, J. G. (2001). Antithrombotic Therapy for Venous Thromboembolic Disease. Chest 119 : 176S-193S [Full Text]
Lane, B., Harrison, M. (2000). Low molecular weight heparin or unfractionated heparin in the treatment of patients with uncomplicated deep vein thrombosis. Emerg. Med. J. 17: 402-403 [Full Text]
Kalafut, M. A., Gandhi, R., Kidwell, C. S., Saver, J. L. (2000). Safety and Cost of Low-Molecular-Weight Heparin as Bridging Anticoagulant Therapy in Subacute Cerebral Ischemia. Stroke 31: 2563-2568 [Abstract] [Full Text]
Tillman, D. J., Charland, S. L., Witt, D. M. (2000). Effectiveness and Economic Impact Associated With a Program for Outpatient Management of Acute Deep Vein Thrombosis in a Group Model Health Maintenance Organization. Arch Intern Med 160: 2926-2932 [Abstract] [Full Text]
O'Shaughnessy, D., Miles, J., Wimperis, J. (2000). UK patients with deep-vein thrombosis can be safely treated as out-patients. QJM 93: 663-667 [Abstract] [Full Text]
Boccalon, H., Elias, A., Chale, J.-J., Cadene, A., Gabriel, S., for the Vascular Midi-Pyrenees Network Group, (2000). Clinical Outcome and Cost of Hospital vs Home Treatment of Proximal Deep Vein Thrombosis With a Low-Molecular-Weight Heparin: The Vascular Midi-Pyrenees Study. Arch Intern Med 160: 1769-1773 [Abstract] [Full Text]
Streiff, M. B. (2000). Vena caval filters: a comprehensive review. Blood 95: 3669-3677 [Abstract] [Full Text]
Extermann, M., Balducci, L., Lyman, G. H. (2000). What Threshold for Adjuvant Therapy in Older Breast Cancer Patients?. JCO 18: 1709-1717 [Abstract] [Full Text]
Gould, M. K., Garber, A. M. (2000). Cost-Effectiveness of Low-Molecular-Weight Heparins for Deep Venous Thrombosis. ANN INTERN MED 132: 508-509 [Full Text]
Dolovich, L. R., Ginsberg, J. S., Douketis, J. D., Holbrook, A. M., Cheah, G. (2000). A Meta-analysis Comparing Low-Molecular-Weight Heparins With Unfractionated Heparin in the Treatment of Venous Thromboembolism: Examining Some Unanswered Questions Regarding Location of Treatment, Product Type, and Dosing Frequency. Arch Intern Med 160: 181-188 [Abstract] [Full Text]
Hull, R. D., Raskob, G. E., Brant, R. F., Pineo, G. F., Elliott, G., Stein, P. D., Gottschalk, A., Valentine, K. A., Mah, A. F., for the American-Canadian Thrombosis Study Group, (2000). Low-Molecular-Weight Heparin vs Heparin in the Treatment of Patients With Pulmonary Embolism. Arch Intern Med 160: 229-236 [Abstract] [Full Text]
Wakefield, T. W. (2000). The Safety, Efficacy, and Cost Efficiency of Outpatient Treatment of Acute Deep Venous Thrombosis with Low Molecular Weight Heparin. PERSPECT VASC SURG ENDOVASC THER 13: 19-25 [Abstract]
O'Brien, B., Levine, M., Willan, A., Goeree, R., Haley, S., Blackhouse, G., Gent, M. (1999). Economic Evaluation of Outpatient Treatment With Low-Molecular-Weight Heparin for Proximal Vein Thrombosis. Arch Intern Med 159: 2298-2304 [Abstract] [Full Text]
Nicolaides, A.N., Cesarone, M.R., Laurora, G., De Sanctis, M.T., Incandela, L., Barsotti, A., Corsi, M., Vasdekis, S., Christopoulos, D., Lennox, A., Malouf, M., Belcaro, G. (1999). Comparison of Low-Molecular-Weight Heparin, Administered Primarily at Home, with Unfractionated Heparin, Administered in Hospital, and Subcutaneous Heparin, Administered at Home for Deep-Vein Thrombosis. ANGIOLOGY 50: 781-787 [Abstract]
Bick, R. L., Rice, J. (1999). Long-Term Outpatient Dalteparin (Fragmin) Therapy for Arterial and Venous Thrombosis: Efficacy and Safety--A Preliminary Report. CLIN APPL THROMB HEMOST 5: S67-S71 [Abstract]
Zed, P. J., Tisdale, J. E., Borzak, S. (1999). Low-Molecular-Weight Heparins in the Management of Acute Coronary Syndromes. Arch Intern Med 159: 1849-1857 [Abstract] [Full Text]
Weltermann, A., Wolzt, M., Petersmann, K., Czerni, C., Graselli, U., Lechner, K., Kyrle, P. A. (1999). Large Amounts of Vascular Endothelial Growth Factor at the Site of Hemostatic Plug Formation In Vivo. Arterioscler. Thromb. Vasc. Bio. 19: 1757-1760 [Abstract] [Full Text]
Gould, M. K., Dembitzer, A. D., Sanders, G. D., Garber, A. M. (1999). Low-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis: A Cost-Effectiveness Analysis. ANN INTERN MED 130: 789-799 [Abstract] [Full Text]
Gould, M. K., Dembitzer, A. D., Doyle, R. L., Hastie, T. J., Garber, A. M. (1999). Low-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis: A Meta-Analysis of Randomized, Controlled Trials. ANN INTERN MED 130: 800-809 [Abstract] [Full Text]
Aguilar, D., Goldhaber, S. Z. (1999). Clinical Uses of Low-Molecular-Weight Heparins. Chest 115: 1418-1423 [Full Text]
Yusen, R. D., Haraden, B. M., Gage, B. F., Woodward, R. S., Rubin, B. G., Botney, M. D. (1999). Criteria for Outpatient Management of Proximal Lower Extremity Deep Venous Thrombosis. Chest 115: 972-979 [Abstract] [Full Text]
Anderson, D. R., Wells, P. S., Stiell, I., MacLeod, B., Simms, M., Gray, L., Robinson, K. S., Bormanis, J., Mitchell, M., Lewandowski, B., Flowerdew, G. (1999). Thrombosis in the Emergency Department: Use of a Clinical Diagnosis Model to Safely Avoid the Need for Urgent Radiological Investigation. Arch Intern Med 159: 477-482 [Abstract] [Full Text]
Vouyouka, A., Silver, D. (1999). Is Low-Molecular-Weight Heparin the Answer for the Therapy of Acute Deep Vein Thrombosis?. VASC ENDOVASCULAR SURG 33: 125-128
Cohn, S. M., Moller, B. A., Feinstein, A. J., Burns, G. A., Ginzburg, E., Hammers,, L. W. (1999). Prospective Trial of Low-Molecular-Weight Heparin Versus Unfractionated Heparin in Moderately Injured Patients. VASC ENDOVASCULAR SURG 33: 219-223 [Abstract]
Caps, M. T, Meissner, M. H, Tullis, M. J, Polissar, N. L, Manzo, R. A, Zierler, B. K, Chandler, W. L, Strandness, D E. Jr (1999). Venous thrombus stability during acute phase of therapy. Vasc Med 4: 9-14 [Abstract]
Bick, R. L. (1999). Therapy for Venous Thrombosis: Guidelines for a Competent and Cost-effective Approach. CLIN APPL THROMB HEMOST 5: 2-9
Grubb, N. R, Bloomfield, P., Ludlam, C. A (1998). The end of the heparin pump?. BMJ 317: 1540-1542 [Full Text]
Goldhaber, S. Z., Morrison, R. B., Diran, L. L., Creager, M. A., Lee, T. H. Jr (1998). Abbreviated Hospitalization for Deep Venous Thrombosis With the Use of Ardeparin. Arch Intern Med 158: 2325-2328 [Abstract] [Full Text]
Hirsh, J. (1998). Low-Molecular-Weight Heparin : A Review of the Results of Recent Studies of the Treatment of Venous Thromboembolism and Unstable Angina. Circulation 98: 1575-1582 [Full Text]
Liebowitz, R. S. (1998). Deep Venous Thrombosis: Thinking Inside Out. Arch Intern Med 158: 1964-1964 [Full Text]
Heilmann, L., Tempelhoff, G.-F. V., Schneider, D. (1998). State-of the-Art Review : Prevention of Thrombosis in Gynecologic Malignancy. CLIN APPL THROMB HEMOST 4: 153-159
(1998). Low molecular weight heparins for venous thromboembolism. DTB 36: 25-29 [Abstract] [Full Text]
Douketis, J. D., Kearon, C., Bates, S., Duku, E. K., Ginsberg, J. S. (1998). Risk of Fatal Pulmonary Embolism in Patients With Treated Venous Thromboembolism. JAMA 279: 458-462 [Abstract] [Full Text]
Bounameaux, H. (1998). Unfractionated versus low-molecular-weight heparin in the treatment of venous thromboembolism. Vasc Med 3: 41-46 [Abstract]
Prandoni, P., Lensing, A. W., Prins, M. R (1998). Long-term outcomes after deep venous thrombosis of the lower extremities. Vasc Med 3: 57-60 [Abstract]
Valentine, K. A., Hull, R. D., Pineo, G. F. (1998). Low-Molecular-Weight Heparin Therapy and Mortality. PERSPECT VASC SURG ENDOVASC THER 9: 99-108 [Abstract]
Hull, R. D., Raskob, G. E., Brant, R. F., Pineo, G. F., Valentine, K. A. (1997). Relation Between the Time to Achieve the Lower Limit of the APTT Therapeutic Range and Recurrent Venous Thromboembolism During Heparin Treatment for Deep Vein Thrombosis. Arch Intern Med 157: 2562-2568 [Abstract]
Hull, R. D., Raskob, G. E., Brant, R. F., Pineo, G. F., Valentine, K. A. (1997). The Importance of Initial Heparin Treatment on Long-term Clinical Outcomes of Antithrombotic Therapy: The Emerging Theme of Delayed Recurrence. Arch Intern Med 157: 2317-2321 [Abstract]
Anand, S., Ginsberg, J. S., Hirsh, J. (1997). Is There a Relationship Between the Intensity of Heparin Treatment and Recurrent Thomboembolism?. CLIN APPL THROMB HEMOST 3: S64-S67 [Abstract]
Hull, R. D., Pineo, G. F. (1997). Overview of Treatment of Venous Thromboembolism Based on Levels of Evidence. CLIN APPL THROMB HEMOST 3: S68-S71
The Columbus Investigators, (1997). Low-Molecular-Weight Heparin in the Treatment of Patients with Venous Thromboembolism. NEJM 337: 657-662 [Abstract] [Full Text]
Simonneau, G., Sors, H., Charbonnier, B., Page, Y., Laaban, J.-P., Azarian, R., Laurent, M., Hirsch, J.-L., Ferrari, E., Bosson, J.-L., Mottier, D., Beau, B., The Thesee Study Group, (1997). A Comparison of Low-Molecular-Weight Heparin with Unfractionated Heparin for Acute Pulmonary Embolism. NEJM 337: 663-669 [Abstract] [Full Text]
Weitz, J. I. (1997). Low-Molecular-Weight Heparins. NEJM 337: 688-699 [Full Text]
Cohen, M., Demers, C., Gurfinkel, E. P., Turpie, A. G.G., Fromell, G. J., Goodman, S., Langer, A., Califf, R. M., Fox, K. A.A., Premmereur, J., Bigonzi, F., Stephens, J., Weatherley, B., The Efficacy and Safety of Subcutaneous Enoxaparin, (1997). A Comparison of Low-Molecular-Weight Heparin with Unfractionated Heparin for Unstable Coronary Artery Disease. NEJM 337: 447-452 [Abstract] [Full Text]
Young, E., Podor, T. J., Venner, T., Hirsh, J. (1997). Induction of the Acute-Phase Reaction Increases Heparin-Binding Proteins in Plasma. Arterioscler. Thromb. Vasc. Bio. 17: 1568-1574 [Abstract] [Full Text]
Anand, S. S., Brimble, S., Ginsberg, J. S. (1997). Management of Iliofemoral Thrombosis in a Pregnant Patient With Heparin Resistance. Arch Intern Med 157: 815-816 [Abstract]
Hull, R. D., Raskob, G. E., Rosenbloom, D., Pineo, G. F., Lerner, R. G., Gafni, A., Trowbridge, A. A., Elliott, C. G., Green, D., Feinglass, J., Feldstein, W., Brant, R. (1997). Treatment of Proximal Vein Thrombosis With Subcutaneous Low-Molecular-Weight Heparin vs Intravenous Heparin: An Economic Perspective. Arch Intern Med 157: 289-294 [Abstract]
Owings, J. T., Blaisdell, F. W. (1996). Low-Dose Heparin Thromboembolism Prophylaxis. Arch Surg 131: 1069-1073 [Abstract]
Anand, S., Ginsberg, J. S., Kearon, C., Gent, M., Hirsh, J. (1996). The Relation Between the Activated Partial Thromboplastin Time Response and Recurrence in Patients With Venous Thrombosis Treated With Continuous Intravenous Heparin. Arch Intern Med 156: 1677-1681 [Abstract]
Ravn, H. B., Bregengaard, C., Vissinger, H., Ostergaard, P., Holst, J., Nielsen, H. K., Kristensen, S. D., Husted, S. E. (1996). Effect of Low-Molecular-Weight Heparin (Tinzaparin) and Unfractionated Heparin on Platelet Aggregation. CLIN APPL THROMB HEMOST 2: 209-212 [Abstract]
Levine, M., Gent, M., Hirsh, J., Leclerc, J., Anderson, D., Weitz, J., Ginsberg, J., Turpie, A. G., Demers, C., Kovacs, M., Geerts, W., Kassis, J., Desjardins, L., Cusson, J., Cruickshank, M., Powers, P., Brien, W., Haley, S., Willan, A. (1996). A Comparison of Low-Molecular-Weight Heparin Administered Primarily at Home with Unfractionated Heparin Administered in the Hospital for Proximal Deep-Vein Thrombosis. NEJM 334: 677-681 [Abstract] [Full Text]
Koopman, M. M.W., Prandoni, P., Piovella, F., Ockelford, P. A., Brandjes, D. P.M., van der Meer, J., Gallus, A. S., Simonneau, G., Chesterman, C. H., Prins, M. H., Bossuyt, P. M.M., de Haes, H., van den Belt, A. G.M., Sagnard, L., d'Azemar, P., Buller, H. R., The Tasman Study Group, (1996). Treatment of Venous Thrombosis with Intravenous Unfractionated Heparin Administered in the Hospital as Compared with Subcutaneous Low-Molecular-Weight Heparin Administered at Home. NEJM 334: 682-687 [Abstract] [Full Text]
Hull, R. D., Feldstein, W., Stein, P. D., Pineo, G. F. (1996). Cost-effectiveness of Pulmonary Embolism Diagnosis. Arch Intern Med 156: 68-72 [Abstract]
Kay, R., Wong, K. S., Yu, Y. L., Chan, Y. W., Tsoi, T. H., Ahuja, A. T., chan, F. L., Fong, K. Y., Law, C. B., Wong, A., Woo, J. (1995). Low-Molecular-Weight Heparin for the Treatment of Acute Ischemic Stroke. NEJM 333: 1588-1594 [Abstract] [Full Text]
Agnelli, G., Iorio, A., Renga, C., Boschetti, E., Nenci, G. G., Ofosu, F. A., Hirsh, J. (1995). Prolonged Antithrombin Activity of Low-Molecular-Weight Heparins : Clinical Implications for the Treatment of Thromboembolic Diseases. Circulation 92: 2819-2824 [Abstract] [Full Text]
Eichinger, S., Wolzt, M., Schneider, B., Nieszpaur-Los, M., Heinrichs, H., Lechner, K., Eichler, H.-G., Kyrle, P. A. (1995). Effects of Recombinant Hirudin (r-Hirudin, HBW 023) on Coagulation and Platelet Activation In Vivo : Comparison With Unfractionated Heparin and a Low-Molecular-Weight Heparin Preparation (Fragmin). Arterioscler. Thromb. Vasc. Bio. 15: 886-892 [Abstract] [Full Text]
Warkentin, T. E., Levine, M. N., Hirsh, J., Horsewood, P., Roberts, R. S., Gent, M., Kelton, J. G. (1995). Heparin-Induced Thrombocytopenia in Patients Treated with Low-Molecular-Weight Heparin or Unfractionated Heparin. NEJM 332: 1330-1336 [Abstract] [Full Text]
Lensing, A. W. A., Prins, M. H., Davidson, B. L., Hirsh, J. (1995). Treatment of Deep Venous Thrombosis With Low-Molecular-Weight Heparins: A Meta-analysis. Arch Intern Med 155: 601-607 [Abstract]
Hull, R. D., Raskob, G. E., Pineo, G. F., Brant, R. F. (1995). The Treatment of Proximal Vein Thrombosis with Subcutaneous Low-Mole Molecular-Weight Heparin Compared with Continuous Intravenous Heparin. CLIN APPL THROMB HEMOST 1: 151-159 [Abstract]
Aburahma, A. F. (1995). Treatment Alternatives for Deep Venous Thrombosis in Pregnancy: Anticoagulation vs. Vena Caval Filtration Devices. PERSPECT VASC SURG ENDOVASC THER 8: 98-107
Weinmann, E. E., Salzman, E. W. (1994). Deep-Vein Thrombosis. NEJM 331: 1630-1641 [Full Text]
Leizorovicz, A, Simonneau, G, Decousus, H, Boissel, J P (1994). Comparison of efficacy and safety of low molecular weight heparins and unfractionated heparin in initial treatment of deep venous thrombosis: a meta-analysis. BMJ 309: 299-304 [Abstract] [Full Text]
Elliott, C. G., Hiltunen, S. J., Suchyta, M., Hull, R. D., Raskob, G. E., Pineo, G. F., Jensen, R. L., Yeates, S., Kitterman, N. (1994). Physician-Guided Treatment Compared With a Heparin Protocol for Deep Vein Thrombosis. Arch Intern Med 154: 999-1004 [Abstract]
Gentile, A. T., DeLoughery, T. G., Porter, J. M. (1994). Novel Antithrombotic Agents in Vascular Surgery. PERSPECT VASC SURG ENDOVASC THER 7: 57-72
Simonneau, G., Charbonnier, B., Decousus, H., Planchon, B., Ninet, J., Sie, P., Silsiguen, M., Combe, S. (1993). Subcutaneous Low-Molecular-Weight Heparin Compared With Continuous IntravenoUnfractionated Unfractionated Heparin in the Treatment of Proximal Deep Vein Thrombosis. Arch Intern Med 153: 1541-1546 [Abstract]
Hastings, G. E., Seery, D. S., Vine, D. L. (1993). Recent Developments in the Diagnosis, Treatment, and Prevention of Pulmonary Embolism. Arch Fam Med 2: 655-669 [Abstract]

Comments and questions? Please contact us.